The latter implicates to address the often sensitive issue of sexual and gender diversity: the broad variation in identities, expressions, behaviours and feelings of attraction we see in human sexual orientation and gender identity (SOGI) worldwide. This group is often referred to as ‘sexual minorities’ or by its acronym: LGBT, when addressing their health needs and advocate for human rights related to SOGI.
Sexual and gender diversity: what do we mean?
A same-sex orientation can manifest itself in three ways: attraction, behaviour and/or identity. But not all people with a same sex attraction and/or behaviour want to or can identify as homosexual (lesbian, gay) or as bisexual and be open about this. In this case people are often categorized as MSM (men who have sex with men) or WSW (women who have sex with women).
Beside variances in sexual orientation, people can vary in their gender identity. Sometimes their felt gender identity does not correspond with the gender/sex (male or female) assigned at birth. Some of these people wish to live in the other gender role, in expression only, or also physically through a bodily transition to the other gender with hormones and/or surgery.
We speak of transgender people, or when surgery is done transsexual people, to refer to this gender variances. Transgender people can have every sexual orientation, and hence can identify either as heterosexual, lesbian, gay or bisexual, but also as transgender or queer, or without any such label.
‘Sexual minorities’, who do not conform to predominant heterosexual and gender norms, are often faced with marginalization, stigmatization, discrimination and even criminalization. This affects their well-being and their health, and limits their access to sexual health services, information and support.
Making programs and services more LGBT-inclusive
In many parts of the world, LGBT people face stigma, discrimination and even criminalizing, and have no or only limited access to appropriate HIV and sexual and reproductive health information or services. Despite many SRHR organizations feel sympathetic towards the principle of LGBT people deserving equal treatment, their experience and technical capacity is often limited. In our opinion every SRHR provider should know and be able to non-judgementally talk about SOGI in order to provide affirmative and inclusive education and health care.
In the 2011 – 2015 UFBR program of the Dutch SRHR Alliance, Rutgers and several country SRHR Alliances ran programs to support in-country partners and LGBT organizations, in their efforts to address and mainstream sexual and gender diversity in a context of homophobia, transphobia and criminalization. Best practices and strategies to mainstream sexual and gender diversity into programs and services were explored and evaluated in Indonesia, Kenya, Malawi and Tanzania.
Building bridges towards mainstreaming of sexual and gender diversity in SRHR organisations - lessons learned in Africa and Asia